1
|
Jin L, Chen Z, Sun Y, Tian Z, Yi X, Huang Y. Advancements in Uric Acid Stone Detection: Integrating Deep Learning with CT Imaging and Clinical Assessments in the Upper Urinary Tract. Urol Int 2024; 108:234-241. [PMID: 38432217 DOI: 10.1159/000538133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/22/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Among upper urinary tract stones, a significant proportion comprises uric acid stones. The aim of this study was to use machine learning techniques to analyze CT scans and blood and urine test data, with the aim of establishing multiple predictive models that can accurately identify uric acid stones. METHODS We divided 276 patients with upper urinary tract stones into two groups: 48 with uric acid stones and 228 with other types, identified using Fourier-transform infrared spectroscopy. To distinguish the stone types, we created three types of deep learning models and extensively compared their classification performance. RESULTS Among the three major types of models, considering accuracy, sensitivity, and recall, CLNC-LR, IMG-support vector machine (SVM), and FUS-SVM perform the best. The accuracy and F1 score for the three models were as follows: CLNC-LR (82.14%, 0.7813), IMG-SVM (89.29%, 0.89), and FUS-SVM (29.29%, 0.8818). The area under the curves for classes CLNC-LR, IMG-SVM, and FUS-SVM were 0.97, 0.96, and 0.99, respectively. CONCLUSION This study shows the feasibility of utilizing deep learning to assess whether urinary tract stones are uric acid stones through CT scans, blood, and urine tests. It can serve as a supplementary tool for traditional stone composition analysis, offering decision support for urologists and enhancing the effectiveness of diagnosis and treatment.
Collapse
Affiliation(s)
- Lichen Jin
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China,
| | - Zongxin Chen
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yizhang Sun
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhen Tian
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xincheng Yi
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yuhua Huang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
| |
Collapse
|
2
|
Zhang J, Li K, Chen H, Hu X, Guo Z, Chen S, Zheng F, Cheng W, Mu Q, Lan Y, Chen P. Retrospective analysis of urinary tract stone composition in a Chinese ethnic minority colony based on Fourier transform infrared spectroscopy. Sci Rep 2023; 13:13453. [PMID: 37596395 PMCID: PMC10439141 DOI: 10.1038/s41598-023-40603-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/14/2023] [Indexed: 08/20/2023] Open
Abstract
To analyze the relationship between the composition of urinary stones and various influencing factors in the Enshi region. We used FT-IR to examine the composition of 1092 stone samples. Combined with the relevant clinical materials, the data were analyzed using both one-dimensional statistical methods and multivariate statistical methods. The study included 1092 stone samples, classified as follows: 457 (41.8%) with a single component, 453 (41.5%) with two components, 149 (13.6%) with three components, and 33 (3.0%) with four components. Stones were categorized into five types: Calcium Oxalate (CaOx) (76.4%), carbapatite (CaP) (9.3%), Struvite (ST) (8.3%), Uric Acid (UA) (4.9%), and Others (1.0%). Age, gender, urinary tract infection (UTI), family history of urinary stones (FH), hyperuricemia (HUA) and stone location were significantly associated with stone type. Logistic regression revealed that females and UTI were relative risk factors for predicting CaP and ST, while FH and HUA were relative risk factors for predicting UA. Our study indicates that the overall composition of urinary tract stones in the Enshi region is consistent with that of the entire China. Additionally, the predisposing factors for stone formation vary in terms of gender, age, FH, UTI, hyperuricemia HUA, and stone location.
Collapse
Affiliation(s)
- Junfeng Zhang
- Department of Urology, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, China
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Kailing Li
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Hongbo Chen
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Xiaohui Hu
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Zicheng Guo
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Su Chen
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Fu Zheng
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Wusong Cheng
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Qian Mu
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Yong Lan
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China.
| | - Peng Chen
- Department of Urology, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, China.
| |
Collapse
|
3
|
Li X, Song S, Yao J, Liao X, Chen M, Zhai J, Lang L, Lin C, Zhang N, Yuan C, Li C, Li H, Wu X, Lin J, Li C, Wang Y, Lyu J, Li M, Zhou Z, Yang M, Jia H, Yan J. Autofluorescence spectral analysis for detecting urinary stone composition in emulated intraoperative ambient. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2023; 300:122913. [PMID: 37262970 DOI: 10.1016/j.saa.2023.122913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 05/23/2023] [Indexed: 06/03/2023]
Abstract
The prevalence and disease burden of urolithiasis has increased substantially worldwide in the last decade, and intraluminal holmium laser lithotripsy has become the primary treatment method. However, inappropriate laser energy settings increase the risk of perioperative complications, largely due to the lack of intraoperative information on the stone composition, which determines the stone melting point. To address this issue, we developed a fiber-based fluorescence spectrometry method that detects and classifies the autofluorescence spectral fingerprints of urinary stones into three categories: calcium oxalate, uric acid, and struvite. By applying the support vector machine (SVM), the prediction accuracy achieved 90.28 % and 96.70% for classifying calcium stones versus non-calcium stones and uric acid versus struvite, respectively. High accuracy and specificity were achieved for a wide range of working distances and angles between the fiber tip and stone surface in an emulated intraoperative ambient. Our work establishes the methodological basis for engineering a clinical device that achieves real-time, in situ classification of urinary stones for optimizing the laser ablation parameters and reducing perioperative complications in lithotripsy.
Collapse
Affiliation(s)
- Xing Li
- Advanced Institute for Brain and Intelligence, School of Physical Science and Technology, Guangxi University, Nanning 530004, China; Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Siji Song
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Jiwei Yao
- Center for Neurointelligence, School of Medicine, Chongqing University, Chongqing 400030, China
| | - Xiang Liao
- Center for Neurointelligence, School of Medicine, Chongqing University, Chongqing 400030, China
| | - Min Chen
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Jinliang Zhai
- Advanced Institute for Brain and Intelligence, School of Physical Science and Technology, Guangxi University, Nanning 530004, China
| | - Lang Lang
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Chunyan Lin
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Na Zhang
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Chunhui Yuan
- Chongqing Institute for Brain and Intelligence, Guangyang Bay Laboratory, Chongqing 400064, China
| | - Chunxia Li
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Hui Li
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Xiaojun Wu
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Jing Lin
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Chunlian Li
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Yan Wang
- Brain Research Instrument Innovation Center, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China
| | - Jing Lyu
- Brain Research Instrument Innovation Center, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China
| | - Min Li
- Brain Research Instrument Innovation Center, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China
| | - Zhenqiao Zhou
- Brain Research Instrument Innovation Center, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China
| | - Mengke Yang
- Brain Research Instrument Innovation Center, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China; UK Dementia Research Institute at UCL, University College London, WC1E 6BT London, UK.
| | - Hongbo Jia
- Advanced Institute for Brain and Intelligence, School of Physical Science and Technology, Guangxi University, Nanning 530004, China; Brain Research Instrument Innovation Center, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China; Leibniz Institute for Neurobiology, Magdeburg 39118, Germany.
| | - Junan Yan
- Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China; Center for Neurointelligence, School of Medicine, Chongqing University, Chongqing 400030, China; Chongqing Institute for Brain and Intelligence, Guangyang Bay Laboratory, Chongqing 400064, China.
| |
Collapse
|
4
|
Mercurio M, Izzo F, Gatta GD, Salzano L, Lotrecchiano G, Saldutto P, Germinario C, Grifa C, Varricchio E, Carafa A, Di Meo MC, Langella A. May a comprehensive mineralogical study of a jackstone calculus and some other human bladder stones unveil health and environmental implications? ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2022; 44:3297-3320. [PMID: 34529244 DOI: 10.1007/s10653-021-01083-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/24/2021] [Indexed: 06/13/2023]
Abstract
This paper represents the first result of an active collaboration between the University of Sannio and the San Pio Hospital (Benevento, Italy), started in the 2018, that aims to a detailed mineralogical investigation of urinary stones of patients from Campania region. Herein, selected human bladder stones have been deeply characterized for clinical purposes and environmental biomonitoring, focusing on the importance to evaluate the concentration and distribution of undesired trace elements by means of microscopic techniques in the place of conventional wet chemical analyses. A rare bladder stone with a sea-urchin appearance, known as jackstone calculus, were also investigated (along with bladder stones made of uric acid and brushite) by means a comprehensive analytical approach, including Synchrotron X-ray Diffraction and Simultaneous Thermal Analyses. Main clinical assumptions were inferred according to the morpho-constitutional classification of bladder stones and information about patient's medical history and lifestyle. In most of the analyzed uroliths, undesired trace elements such as copper, cadmium, lead, chromium, mercury and arsenic have been detected and generally attributable to environmental pollution or contaminated food. Simultaneous occurrence of selenium and mercury should denote a methylmercury detoxification process, probably leading to the formation of a very rare HgSe compound known as tiemannite.
Collapse
Affiliation(s)
- M Mercurio
- Dipartimento di Scienze E Tecnologie, Università degli Studi del Sannio, Via F. De Sanctis, 82100, Benevento, Italy
| | - F Izzo
- Dipartimento di Scienze E Tecnologie, Università degli Studi del Sannio, Via F. De Sanctis, 82100, Benevento, Italy.
| | - Giacomo Diego Gatta
- Dipartimento Scienze della Terra, Università degli Studi di Milano, Via Botticelli 23, 20133, Milan, Italy
| | - L Salzano
- UOC Urologia, Azienda Ospedaliera San Pio di Benevento, Via dell'Angelo 82100, Benevento, Italy
| | - G Lotrecchiano
- UOC Urologia, Azienda Ospedaliera San Pio di Benevento, Via dell'Angelo 82100, Benevento, Italy
| | - P Saldutto
- UOC Urologia, Azienda Ospedaliera San Pio di Benevento, Via dell'Angelo 82100, Benevento, Italy
| | - C Germinario
- Dipartimento di Scienze E Tecnologie, Università degli Studi del Sannio, Via F. De Sanctis, 82100, Benevento, Italy
| | - C Grifa
- Dipartimento di Scienze E Tecnologie, Università degli Studi del Sannio, Via F. De Sanctis, 82100, Benevento, Italy
| | - E Varricchio
- Dipartimento di Scienze E Tecnologie, Università degli Studi del Sannio, Via F. De Sanctis, 82100, Benevento, Italy
| | - A Carafa
- Dipartimento di Scienze E Tecnologie, Università degli Studi del Sannio, Via F. De Sanctis, 82100, Benevento, Italy
| | - Maria Chiara Di Meo
- Dipartimento di Scienze E Tecnologie, Università degli Studi del Sannio, Via F. De Sanctis, 82100, Benevento, Italy
| | - A Langella
- Dipartimento di Scienze della Terra, dell'Ambiente e delle Risorse, Università degli Studi di Napoli Federico II, Complesso Universitario Di Monte Sant'Angelo, Edificio 10, Via Vicinale Cupa Cintia 21, 80126, Naples, Italy
| |
Collapse
|
5
|
Kim US, Kwon HS, Yang W, Lee W, Choi C, Kim JK, Lee SH, Rim D, Han JH. Prediction of the composition of urinary stones using deep learning. Investig Clin Urol 2022; 63:441-447. [PMID: 35670006 PMCID: PMC9262483 DOI: 10.4111/icu.20220062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/31/2022] [Accepted: 04/17/2022] [Indexed: 12/13/2022] Open
Abstract
PURPOSE This study aimed to predict the composition of urolithiasis using deep learning from urinary stone images. MATERIALS AND METHODS We classified 1,332 stones into 31 classes according to the stone composition. The top 4 classes with a frequency of 110 or more (class 1: calcium oxalate monohydrate [COM] 100%, class 2: COM 80%+struvite 20%, class 3: COM 60%+calcium oxalate dihydrate [COD] 40%, class 4: uric acid 100%) were selected. With the 965 stone images of the top 4 classes, we used the seven convolutional neural networks (CNN) to classify urinary stones and compared their classification performances. RESULTS Among the seven models, Xception_Ir0.001 showed the highest accuracy, precision, and recall and was selected as the CNN model to predict the stone composition. The sensitivity and specificity for the 4 classes by Xception_Ir0.001 were as follows: class 1 (94.24%, 91.73%), class 2 (85.42%, 96.14%), class 3 (86.86%, 99.59%), and class 4 (94.96%, 98.82%). The sensitivity and specificity of the individual components of the stones were as follows. COM (98.82%, 94.96%), COD (86.86%, 99.64%), struvite (85.42%, 95.59%), and uric acid (94.96%, 98.82%). The area under the curves for class 1, 2, 3, and 4 were 0.98, 0.97, 1.00, and 1.00, respectively. CONCLUSIONS This study showed the feasibility of deep learning for the diagnostic ability to assess urinary stone composition from images. It can be an alternative tool for conventional stone analysis and provide decision support to urologists, improving the effectiveness of diagnosis and treatment.
Collapse
Affiliation(s)
- Ui Seok Kim
- Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Hyo Sang Kwon
- Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Wonjong Yang
- Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Wonchul Lee
- Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Changil Choi
- Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Jong Keun Kim
- Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Seong Ho Lee
- Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Dohyoung Rim
- Department of Cognitive Science, Yonsei University, Seoul, Korea
| | - Jun Hyun Han
- Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
| |
Collapse
|
6
|
Bostanghadiri N, Ziaeefar P, Sameni F, Mahmoudi M, Hashemi A, Darban-Sarokhalil D. The controversial association of gut and urinary microbiota with kidney stone formation. Microb Pathog 2021; 161:105257. [PMID: 34687841 DOI: 10.1016/j.micpath.2021.105257] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 09/24/2021] [Accepted: 10/15/2021] [Indexed: 12/17/2022]
Abstract
Nephrolithiasis (kidney stones) is one of the most common chronic kidney diseases that are typically more common among adult men comparing to adult women. The prevalence of this disease is increasing which is influenced by genetic and environmental factors. Kidney stones are mainly composed of calcium oxalate and urinary oxalate which is considered a dangerous factor in their formation. Besides diverse leading reasons in the progression of nephrolithiasis, the gut and urinary microbiome has been recognized as a major player in the development or prevention of it. These microbes produce metabolites that have diverse effects on host biological functions. Therefore, Changes in the composition and structure of the microbiome (dysbiosis) have been implicated in various diseases. The present review focuses on the roles of gut and urinary in kidney stone formation.
Collapse
Affiliation(s)
- Narjess Bostanghadiri
- -Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Pardis Ziaeefar
- -School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sameni
- -Department of Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Mohammad Mahmoudi
- -Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Hashemi
- -Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Davood Darban-Sarokhalil
- -Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
7
|
Yamazaki K, Miyazawa K, Nida Y, Furuichi K, Yokoyama H. Rapidly progressive kidney dysfunction and crystal casts associated with adenine phosphoribosyltransferase (APRT) deficiency-lessons for the clinical nephrologist. J Nephrol 2021; 34:2147-2149. [PMID: 33826114 DOI: 10.1007/s40620-021-01042-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/26/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Keita Yamazaki
- Department of Nephrology, School of Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan.
| | - Katsuhito Miyazawa
- Department of Urology, Kanazawa Medical University, Uchinada, Kahoku, Ishikawa, Japan
| | - Yo Nida
- Center for Clinical Genomics, Kanazawa Medical University Hospital, Uchinada, Kahoku, Ishikawa, Japan
| | - Kengo Furuichi
- Department of Nephrology, School of Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan
| | - Hitoshi Yokoyama
- Department of Nephrology, School of Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan
| |
Collapse
|
8
|
Primiano A, Persichilli S, Di Giacinto F, Ciasca G, Baroni S, Ferraro PM, De Spirito M, Urbani A, Gervasoni J. Attenuated total reflection-Fourier transform infrared spectroscopy (ATR-FTIR) detection as a rapid and convenient screening test for cystinuria. Clin Chim Acta 2021; 518:128-133. [PMID: 33794142 DOI: 10.1016/j.cca.2021.03.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/19/2021] [Accepted: 03/20/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cystinuria is an inborn congenital disorder characterised by a defective cystine metabolism resulting in the formation of cystine stones. The Brand's test, used for diagnosis, requires dangerous substances, so has been replaced with high-performance liquid chromatography with fluorimetric detection (HPLC-FL). However, this technique requires the use of complex equipment. Infrared spectroscopy, universally used for stone analysis, recently was employed to detect insoluble cystine in urine. The aim of this study is to evaluate Infrared Spectroscopy combined with chemometric analysis as screening method to identify those patients requiring confirmation by HPLC-FL analysis. METHODS We examined 24 h urine specimens from 57 patients. The quantitative analysis was performed by HPLC-FL. The infrared spectroscopic urine sediment analysis was performed with an ATR accessory (ATR-FTIR). Urine is centrifuged, the supernatant is discarded, and the sediment is dried on to the ATR prism surface. Statistical analysis was performed using a custom-made software developed in MATLAB environment. RESULTS The HPLC-FL determination showed a normal excretion of cystine in 49 samples and an abnormal excretion in the remaining 8 samples. The ATR-FTIR analysis combined with a statistical approach gives a sensitivity of 1.0 and a specificity of 0.82 were obtained. CONCLUSIONS The introduction of the ATR-FTIR technique in our clinical laboratory setting may reduce time and cost analysis for diagnosis of cystinuria.
Collapse
Affiliation(s)
- Aniello Primiano
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Dipartimento di Scienze Biotecnologiche di base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Silvia Persichilli
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Dipartimento di Scienze Biotecnologiche di base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Flavio Di Giacinto
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Dipartimento di Neuroscienze, Sezione di Fisica, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Gabriele Ciasca
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Dipartimento di Neuroscienze, Sezione di Fisica, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Silvia Baroni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Dipartimento di Scienze Biotecnologiche di base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Pietro Manuel Ferraro
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Dipartimento di Medicina e chirurgia traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Marco De Spirito
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Dipartimento di Neuroscienze, Sezione di Fisica, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Andrea Urbani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Dipartimento di Scienze Biotecnologiche di base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Roma, Italy.
| | - Jacopo Gervasoni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
| |
Collapse
|
9
|
Gervasoni J, Primiano A, Marini F, Sabino A, Biancolillo A, Calvani R, Picca A, Marzetti E, Persichilli S, Urbani A, Servidei S, Primiano G. Fourier-Transform Infrared Spectroscopy of Skeletal Muscle Tissue: Expanding Biomarkers in Primary Mitochondrial Myopathies. Genes (Basel) 2020; 11:genes11121522. [PMID: 33352713 PMCID: PMC7766922 DOI: 10.3390/genes11121522] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 12/17/2022] Open
Abstract
Primary mitochondrial myopathies (PMM) are a group of mitochondrial disorders characterized by a predominant skeletal muscle involvement. The aim of this study was to evaluate whether the biochemical profile determined by Fourier-transform infrared (FTIR) spectroscopic technique would allow to distinguish among patients affected by progressive external ophthalmoplegia (PEO), the most common PMM presentation, oculopharyngeal muscular dystrophy (OPMD), and healthy controls. Thirty-four participants were enrolled in the study. FTIR spectroscopy was found to be a sensitive and specific diagnostic marker for PEO. In particular, FTIR spectroscopy was able to distinguish PEO patients from those affected by OPMD, even in the presence of histological findings similar to mitochondrial myopathy. At the same time, FTIR spectroscopy differentiated single mtDNA deletion and mutations in POLG, the most common nuclear gene associated with mitochondrial diseases, with high sensitivity and specificity. In conclusion, our data suggest that FTIR spectroscopy is a valuable biodiagnostic tool for the differential diagnosis of PEO with a high ability to also distinguish between single mtDNA deletion and mutations in POLG gene based on specific metabolic transitions.
Collapse
Affiliation(s)
- Jacopo Gervasoni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (J.G.); (A.P.); (R.C.); (A.P.); (E.M.); (S.P.); (A.U.); (S.S.)
| | - Aniello Primiano
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (J.G.); (A.P.); (R.C.); (A.P.); (E.M.); (S.P.); (A.U.); (S.S.)
- Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
| | - Federico Marini
- Department of Chemistry, Sapienza Università di Roma, 00185 Rome, Italy;
| | - Andrea Sabino
- Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
| | - Alessandra Biancolillo
- Department of Physical and Chemical Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Riccardo Calvani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (J.G.); (A.P.); (R.C.); (A.P.); (E.M.); (S.P.); (A.U.); (S.S.)
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, 17177 Stockholm, Sweden
| | - Anna Picca
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (J.G.); (A.P.); (R.C.); (A.P.); (E.M.); (S.P.); (A.U.); (S.S.)
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, 17177 Stockholm, Sweden
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (J.G.); (A.P.); (R.C.); (A.P.); (E.M.); (S.P.); (A.U.); (S.S.)
- Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
| | - Silvia Persichilli
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (J.G.); (A.P.); (R.C.); (A.P.); (E.M.); (S.P.); (A.U.); (S.S.)
- Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
| | - Andrea Urbani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (J.G.); (A.P.); (R.C.); (A.P.); (E.M.); (S.P.); (A.U.); (S.S.)
- Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
| | - Serenella Servidei
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (J.G.); (A.P.); (R.C.); (A.P.); (E.M.); (S.P.); (A.U.); (S.S.)
- Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
| | - Guido Primiano
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (J.G.); (A.P.); (R.C.); (A.P.); (E.M.); (S.P.); (A.U.); (S.S.)
- Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
- Correspondence: ; Tel.: +39-06-30154279
| |
Collapse
|
10
|
Bashan I, Bozlu M. The possible litholytic effect of Ononis Spinosa L. on various human kidney stones—An in vitro experimental evaluation. J Herb Med 2020. [DOI: 10.1016/j.hermed.2020.100345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
11
|
A Specific Urinary Amino Acid Profile Characterizes People with Kidney Stones. DISEASE MARKERS 2020; 2020:8848225. [PMID: 32670436 PMCID: PMC7345965 DOI: 10.1155/2020/8848225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/08/2020] [Accepted: 06/15/2020] [Indexed: 12/28/2022]
Abstract
Background Urolithiasis is the process of stone formation in the urinary tract. Its etiology is only partly known, and efficient therapeutic approaches are currently lacking. Metabolomics is increasingly used in biomarkers discovery for its ability to identify mediators of relevant (patho)physiological processes. Amino acids may be involved in kidney stone formation. The aim of the present study was to investigate the presence of an amino acid signature in stone former urine through a targeted metabolomic approach. Methods A panel of 35 amino acids and derivatives was assessed in urines from 15 stone former patients and 12 healthy subjects by UPLC-MS. Partial Least Squares Discriminant Analysis (PLS-DA) was used to define amino acid profiles of cases and controls. Results and Discussion. Our approach led to the definition of a specific amino acid fingerprint in people with kidney stones. A urinary amino acid profile of stone formers was characterized by lower levels of α-aminobutyric acid, asparagine, ethanolamine, isoleucine, methionine, phenylalanine, serine, tryptophan, and valine. Metabolomic analysis may lend insights into the pathophysiology of urolithiasis and allow tracking this prevalent condition over time.
Collapse
|
12
|
Stone composition and vascular calcifications in patients with nephrolithiasis. J Nephrol 2019; 32:589-594. [DOI: 10.1007/s40620-019-00619-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 05/26/2019] [Indexed: 12/23/2022]
|
13
|
Ferraro PM, Vittori M, Macis G, D'Addessi A, Lombardi G, Palmisano C, Gervasoni J, Primiano A, Bassi PF, Gambaro G. Changes in renal papillary density after hydration therapy in calcium stone formers. BMC Urol 2018; 18:101. [PMID: 30419887 PMCID: PMC6233505 DOI: 10.1186/s12894-018-0415-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 10/26/2018] [Indexed: 11/26/2022] Open
Abstract
Background Previous studies have shown that, compared with non-stone formers, stone formers have a higher papillary density measured with computer tomography (CT) scan. The effect of increased hydration on such papillary density in idiopathic calcium stone formers is not known. Methods Patients with recurrent calcium oxalate stones undergoing endourological procedures for renal stones at our Institution from June 2013 to June 2014 were considered eligible for enrolment. Enrolled patients underwent a baseline unenhanced CT scan before the urological procedure; after endoscopic removal of their stones, the patients were instructed to drink at least 2 L/day of a hypotonic, oligomineral water low in sodium and minerals (fixed residue at 180 °C < 200 mg/L) for at least 12 months. Finally, the patients underwent a follow-up unenhanced CT scan during hydration regimen. Results Twenty-five patients were prospectively enrolled and underwent baseline and follow-up CT scans. At baseline, mean papillary density was 43.2 ± 6.6 Hounsfield Units (HU) (43.2 ± 6.7 for the left kidney and 42.8 ± 7.1 HU for the right kidney). At follow-up and after at least 12 months of hydration regimen, mean papillary density was significantly reduced at 35.4 ± 4.2 HU (35.8 ± 5.0 for the left kidney and 35.1 ± 4.2 HU for the right kidney); the mean difference between baseline and follow-up was − 7.8 HU (95% confidence interval − 10.6 to − 5.1 HU, p < 0.001). Conclusions Increased fluid intake in patients with recurrent calcium oxalate stones was associated with a significant reduction in renal papillary density. Trial registration NCT03343743, 15/11/2017 (Retrospectively registered).
Collapse
Affiliation(s)
- Pietro Manuel Ferraro
- U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia. .,Università Cattolica del Sacro Cuore, Roma, Italia.
| | - Matteo Vittori
- U.O.C. Clinica Urologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - Giuseppe Macis
- U.O.C. Radiologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - Alessandro D'Addessi
- U.O.C. Clinica Urologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - Gianmarco Lombardi
- U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - Claudia Palmisano
- U.O.C. Radiologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - Jacopo Gervasoni
- U.O.C. Biochimica Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - Aniello Primiano
- U.O.C. Biochimica Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - Pier Francesco Bassi
- U.O.C. Clinica Urologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - Giovanni Gambaro
- U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.,Università Cattolica del Sacro Cuore, Roma, Italia
| |
Collapse
|
14
|
Kraaij S, Brand HS, van der Meij EH, de Visscher JG. Biochemical composition of salivary stones in relation to stone- and patient-related factors. Med Oral Patol Oral Cir Bucal 2018; 23:e540-e544. [PMID: 30148468 PMCID: PMC6167104 DOI: 10.4317/medoral.22533] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 07/18/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Salivary stones are calcified structures most often found in the main duct of the submandibular or parotid salivary gland. They contain of a core surrounded by laminated layers of organic and inorganic material. MATERIAL AND METHODS Submandibular and parotid sialoliths (n=155) were collected at the department of Oral and Maxillofacial surgery of a general hospital between February 1982 and September 2012. The weight of the sialoliths was determined and the consistency was subjectively classified. Subsequently, the biochemical composition of the stones was determined by wet chemical methods or FT-IR spectrometry. Age and gender of the patients were retrieved from their medical records. Data were statistically analyzed using Fisher's exact tests. RESULTS Sialoliths are mainly composed of inorganic material. Carbonate apatite was identified in 99% of the stones, phosphate in 88%, calcium in 87%, magnesium in 68%, struvite in 44%, oxalate in 38% and carbonate in 35%. Solid salivary stones contain more frequently struvite than stones with a soft consistency (p=0.05). Larger stones (>100mg) contain more frequently carbonate (p=0.05). Stones from older patients (≥38years) showed an almost significant trend towards more frequent presence of phosphate (p=0.083). CONCLUSIONS The biochemical composition of submandibular and parotid sialoliths is related to stone-related factors, probably to age but not to the gender of the patient.
Collapse
Affiliation(s)
- S Kraaij
- Department of Periodontology and Oral Biochemistry, Academic Centre for Dentistry, Amsterdam (ACTA), room 12N-37, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands,
| | | | | | | |
Collapse
|
15
|
Khan AH, Imran S, Talati J, Jafri L. Fourier transform infrared spectroscopy for analysis of kidney stones. Investig Clin Urol 2018; 59:32-37. [PMID: 29333512 PMCID: PMC5754580 DOI: 10.4111/icu.2018.59.1.32] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 11/13/2017] [Indexed: 11/21/2022] Open
Abstract
Purpose To compare the results of a chemical method of kidney stone analysis with the results of Fourier transform infrared (FT-IR) spectroscopy. Materials and Methods Kidney stones collected between June and October 2015 were simultaneously analyzed by chemical and FT-IR methods. Results Kidney stones (n=449) were collected from patients from 1 to 81 years old. Most stones were from adults, with only 11.5% from children (aged 3–16 years) and 1.5% from children aged <2 years. The male to female ratio was 4.6. In adults, the calcium oxalate stone type, calcium oxalate monohydrate (COM, n=224), was the most common crystal, followed by uric acid and calcium oxalate dihydrate (COD, n=83). In children, the most frequently occurring type was predominantly COD (n=21), followed by COM (n=11), ammonium urate (n=10), carbonate apatite (n=6), uric acid (n=4), and cystine (n=1). Core composition in 22 stones showed ammonium urate (n=2), COM (n=2), and carbonate apatite (n=1) in five stones, while uric acid crystals were detected (n=13) by FT-IR. While chemical analysis identified 3 stones as uric acid and the rest as calcium oxalate only. Agreement between the two methods was moderate, with a kappa statistic of 0.57 (95% confidence interval, 0.5–0.64). Disagreement was noted in the analysis of 77 stones. Conclusions FT-IR analysis of kidney stones can overcome many limitations associated with chemical analysis.
Collapse
Affiliation(s)
- Aysha Habib Khan
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Sheharbano Imran
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Jamsheer Talati
- Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Lena Jafri
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| |
Collapse
|
16
|
Improvement of Urinary Stones Analysis Combining Morphological Analysis and Infrared Spectroscopy. J CHEM-NY 2018. [DOI: 10.1155/2018/4621256] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Daudon et al. have developed a complex morphoconstitutional classification of renal stone in six different morphological types and several subtypes. According to this classification, a precise correspondence exists between causes of renal stones and subtypes with a great clinical relevance and can be considering a sort of shortcut for the metabolic diagnosis in renal stone patients. Now the diagnosis of causes of renal stones generally requires repeated biochemical investigations on urine and blood samples and usually remains presumptive. We analyzed 150 urinary stones both by stereoscopic microscopy and Fourier transform infrared spectroscopy. The comparison of 150 stones did not reveal any disagreement. We have only 20 partial agreement, and clinicians agreed that the imprecise information obtained with morphological analysis alone would have missed an important clinical finding only in 3 cases. In conclusion, in our opinion, the analysis of urinary stone must combine two different analytical techniques: morphological analysis by stereomicroscope and biochemical analysis with the FT-IR.
Collapse
|
17
|
De Bruyne S, Speeckaert MM, Delanghe JR. Applications of mid-infrared spectroscopy in the clinical laboratory setting. Crit Rev Clin Lab Sci 2017; 55:1-20. [PMID: 29239240 DOI: 10.1080/10408363.2017.1414142] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Fourier transform mid-infrared (MIR-FTIR) spectroscopy is a nondestructive, label-free, highly sensitive and specific technique that provides complete information on the chemical composition of biological samples. The technique both can offer fundamental structural information and serve as a quantitative analysis tool. Therefore, it has many potential applications in different fields of clinical laboratory science. Although considerable technological progress has been made to promote biomedical applications of this powerful analytical technique, most clinical laboratory analyses are based on spectroscopic measurements in the visible or ultraviolet (UV) spectrum and the potential role of FTIR spectroscopy still remains unexplored. In this review, we present some general principles of FTIR spectroscopy as a useful method to study molecules in specimens by MIR radiation together with a short overview of methods to interpret spectral data. We aim at illustrating the wide range of potential applications of the proposed technique in the clinical laboratory setting with a focus on its advantages and limitations and discussing the future directions. The reviewed applications of MIR spectroscopy include (1) quantification of clinical parameters in body fluids, (2) diagnosis and monitoring of cancer and other diseases by analysis of body fluids, cells, and tissues, (3) classification of clinically relevant microorganisms, and (4) analysis of kidney stones, nails, and faecal fat.
Collapse
Affiliation(s)
- Sander De Bruyne
- a Department of Clinical Chemistry , Ghent University Hospital , Ghent , Belgium
| | | | - Joris R Delanghe
- a Department of Clinical Chemistry , Ghent University Hospital , Ghent , Belgium
| |
Collapse
|
18
|
Zafar MN, Ayub S, Tanwri H, Naqvi SAA, Rizvi SAH. Composition of urinary calculi in infants: a report from an endemic country. Urolithiasis 2017; 46:445-452. [PMID: 29101428 DOI: 10.1007/s00240-017-1010-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 10/24/2017] [Indexed: 11/24/2022]
Abstract
Pediatric urolithiasis remains endemic in low-resource countries where infants constitute 17-40% of all children with urolithiasis. This study reports socio-economic factors, medical history and chemical composition of urinary stones in 976 infants of up to 2 years of age. Between 1992 and 2016, 976 infants presented to our institute with 1038 stones. Chemical composition of stones was analyzed by Fourier transformation infrared spectroscopy (FTIR). The mean age of infants was 19.5 ± 5.74 months with a M:F ratio of 5.5:1. Half (50%) of the infants were rural dwellers, 90% belonged to low socio-economic class and 70% were malnourished. A history of chronic diarrhoea was reported in 13% and urinary tract infections in 5%. The anatomic location was bladder in 487 (46.9%), kidney in 246 (23.6%), ureter in 142 (13.6%), urethra in 2 (0.2%) and 161 (15.5%) were passed spontaneously. Overall frequency of compounds in stones showed ammonium acid urate (AAU) in 772 (74.37%), calcium oxalate (CaOx) in 410 (39.5%). Uric acid (UA) in 119 (11.46%), calcium phosphate apatite (CaP) in 96 (9.25%), magnesium ammonium phosphate (Struvite) in 45 (4.34%), cystine in 12 (1.16%) and xanthine in 40 (3.85%). Frequency of compounds was similar in genders. Infants of age 0-6 months had higher frequency of UA (28%), CaOx (50%) and low AAU (61%) as compared to 11, 39 and 75%, respectively, in 7-24 months (p < 0.049) (p < 0.002) (p < 0.001). Nucleus of stones showed pure AAU in 63 and 43% on the surface due to addition of CaOx, struvite and CaP. Our study has shown that AAU is a major component of stones in infants where the main risk factors are poverty, malnutrition, diarrheal diseases and dehydration.
Collapse
Affiliation(s)
- Mirza Naqi Zafar
- Department of Pathology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
| | - Salma Ayub
- Department of Pathology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Hafsa Tanwri
- Department of Pathology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Syed Ali Anwar Naqvi
- Department of Urology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | | |
Collapse
|
19
|
The systematic classification of urinary stones combine-using FTIR and SEM-EDAX. Int J Surg 2017; 41:150-161. [PMID: 28373152 DOI: 10.1016/j.ijsu.2017.03.080] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 03/29/2017] [Accepted: 03/29/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND To explore underlying mechanism of urinary stones formation, the composition and microstructure of urinary stones were analyzed systematically with a large sample study from China. MATERIALS AND METHODS A total of 2437 urinary stones were obtained from the urology department at our Hospital. The composition of the stones was analyzed by Fourier transform infrared spectroscopy (FTIR). Meanwhile, the microstructure and element distribution were observed with scanning electron microscopy combined with element distribution analysis (SEM-EDAX). RESULTS Urinary stones were classified into eight types, that were consisted of calcium oxalate stones (1301/2437, 53.39%), calcium phosphate stones (131/2437, 5.38%), anhydrous uric acid stones (434/2437, 17.81%), magnesium ammonium phosphate stones (12/2437, 0.49%), sodium urate stones (5/2437, 0.21%), brushite stones (4/2437, 0.16%), cystine stones (3/2437, 0.12%) and mixed stones (547/2437, 22.45%, ten subtypes were included). Under SEM, they displayed distinct microstructures: plank-like, brick-like, polyhedron or paliform crystals for calcium oxalate stones, similar sized echin-sphere or rough bulbiform or tree bark-like crystals for calcium phosphate stones, rotten-wood-like or petrous crystals for anhydrous uric acid stones, globular or gallet-like crystals for magnesium ammonium phosphate stones, sawdust-like crystals for sodium urate stones, broken-wood-like crystals for brushite stones, stacking hexagonal cystine crystals for cystine stones, and two or more of the above crystals for mixed stones. Meanwhile, they also presented distinct elemental composition and distribution by EDAX. CONCLUSIONS Urinary stones can be classified into eight types, and exhibit a diversity of microstructure and elemental compositions in China. The formation process of different types of urinary stones may be diverse.
Collapse
|
20
|
Gambaro G, Croppi E, Coe F, Lingeman J, Moe O, Worcester E, Buchholz N, Bushinsky D, Curhan GC, Ferraro PM, Fuster D, Goldfarb DS, Heilberg IP, Hess B, Lieske J, Marangella M, Milliner D, Preminger GM, Reis Santos JM, Sakhaee K, Sarica K, Siener R, Strazzullo P, Williams JC. Metabolic diagnosis and medical prevention of calcium nephrolithiasis and its systemic manifestations: a consensus statement. J Nephrol 2016; 29:715-734. [PMID: 27456839 PMCID: PMC5080344 DOI: 10.1007/s40620-016-0329-y] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 06/20/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND Recently published guidelines on the medical management of renal stone disease did not address relevant topics in the field of idiopathic calcium nephrolithiasis, which are important also for clinical research. DESIGN A steering committee identified 27 questions, which were proposed to a faculty of 44 experts in nephrolithiasis and allied fields. A systematic review of the literature was conducted and 5216 potentially relevant articles were selected; from these, 407 articles were deemed to provide useful scientific information. The Faculty, divided into working groups, analysed the relevant literature. Preliminary statements developed by each group were exhaustively discussed in plenary sessions and approved. RESULTS Statements were developed to inform clinicians on the identification of secondary forms of calcium nephrolithiasis and systemic complications; on the definition of idiopathic calcium nephrolithiasis; on the use of urinary tests of crystallization and of surgical observations during stone treatment in the management of these patients; on the identification of patients warranting preventive measures; on the role of fluid and nutritional measures and of drugs to prevent recurrent episodes of stones; and finally, on the cooperation between the urologist and nephrologist in the renal stone patients. CONCLUSIONS This document has addressed idiopathic calcium nephrolithiasis from the perspective of a disease that can associate with systemic disorders, emphasizing the interplay needed between urologists and nephrologists. It is complementary to the American Urological Association and European Association of Urology guidelines. Future areas for research are identified.
Collapse
Affiliation(s)
- Giovanni Gambaro
- Department of Nephrology and Dialysis, A. Gemelli University Hospital, Catholic University of the Sacred Heart, Rome, Italy
| | | | - Fredric Coe
- Department of Nephrology, University of Chicago Medicine, Chicago, USA
| | - James Lingeman
- Department of Urology, Indiana University School of Medicine, Indianapolis, USA
| | - Orson Moe
- Department of Internal Medicine, Southwestern Medical Center, University of Texas, Dallas, USA
| | - Elen Worcester
- Department of Nephrology, University of Chicago Medicine, Chicago, USA
| | - Noor Buchholz
- Department of Urological Surgery, Sobeh's Vascular and Medical Center, Dubai, UAE
| | - David Bushinsky
- Department of Nephrology, Medical Center, University of Rochester, Rochester, USA
| | - Gary C Curhan
- Renal Division, Brigham and Women's Hospital, Boston, USA
| | - Pietro Manuel Ferraro
- Department of Nephrology and Dialysis, A. Gemelli University Hospital, Catholic University of the Sacred Heart, Rome, Italy
| | - Daniel Fuster
- Department of Nephrology, University of Bern, Bern, Switzerland
| | - David S Goldfarb
- Department of Nephrology, New York Harbor VA Health Care System, New York, USA
| | | | - Bernard Hess
- Department of Internal Medicine and Nephrology, Klinik Im Park Hospital, Zurich, Switzerland
| | - John Lieske
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, USA
| | - Martino Marangella
- Department of Nephrology, A.S.O Ordine Mauriziano Hospital, Turin, Italy
| | - Dawn Milliner
- Department of Nephrology, Mayo Clinic, Rochester, USA
| | - Glen M Preminger
- Department of Urology, Duke University Medical Center, Durham, USA
| | | | - Khashayar Sakhaee
- Southwestern Medical Center, Mineral Metabolism Research, University of Texas, Dallas, USA
| | - Kemal Sarica
- Department of Urology, Dr. Lutfi KIRDAR Kartal Research and Training Hospital, Istanbul, Turkey
| | | | | | - James C Williams
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indiana, USA
| |
Collapse
|
21
|
Mutlu N, Çiftçi S, Gülecen T, Öztoprak BG, Demir A. Laser-induced breakdown spectroscopy is a reliable method for urinary stone analysis. Turk J Urol 2016; 42:21-6. [PMID: 27011877 DOI: 10.5152/tud.2016.76402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We compared laser-induced breakdown spectroscopy (LIBS) with the traditionally used and recommended X-ray diffraction technique (XRD) for urinary stone analysis. MATERIAL AND METHODS In total, 65 patients with urinary calculi were enrolled in this prospective study. Stones were obtained after surgical or extracorporeal shockwave lithotripsy procedures. All stones were divided into two equal pieces. One sample was analyzed by XRD and the other by LIBS. The results were compared by the kappa (κ) and Spearman's correlation coefficient (rho) tests. RESULTS Using LIBS, 95 components were identified from 65 stones, while XRD identified 88 components. LIBS identified 40 stones with a single pure component, 20 stones with two different components, and 5 stones with three components. XRD demonstrated 42 stones with a single component, 22 stones with two different components, and only 1 stone with three different components. There was a strong relationship in the detection of stone types between LIBS and XRD for stones components (Spearman rho, 0.866; p<0.001). There was excellent agreement between the two techniques among 38 patients with pure stones (κ index, 0.910; Spearman rho, 0.916; p<0.001). CONCLUSION Our study indicates that LIBS is a valid and reliable technique for determining urinary stone composition. Moreover, it is a simple, low-cost, and nondestructive technique. LIBS can be safely used in routine daily practice if our results are supported by studies with larger numbers of patients.
Collapse
Affiliation(s)
- Nazım Mutlu
- Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | | | - Turgay Gülecen
- Clinic of Urology, Hakkari State Hospital, Hakkari, Turkey
| | - Belgin Genç Öztoprak
- Laser Technologies Research and Application Center, Kocaeli University, Kocaeli, Turkey
| | - Arif Demir
- Laser Technologies Research and Application Center, Kocaeli University, Kocaeli, Turkey
| |
Collapse
|
22
|
Interpreting the results of chemical stone analysis in the era of modern stone analysis techniques. J Nephrol 2016; 30:135-140. [PMID: 26956131 DOI: 10.1007/s40620-016-0274-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 02/03/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION AND OBJECTIVE Stone analysis should be performed in all first-time stone formers. The preferred analytical procedures are Fourier-transform infrared spectroscopy (FT-IR) or X-ray diffraction (XRD). However, due to limited resources, chemical analysis (CA) is still in use throughout the world. The aim of the study was to compare FT-IR and CA in well matched stone specimens and characterize the pros and cons of CA. METHODS In a prospective bi-center study, urinary stones were retrieved from 60 consecutive endoscopic procedures. In order to assure that identical stone samples were sent for analyses, the samples were analyzed initially by micro-computed tomography to assess uniformity of each specimen before submitted for FTIR and CA. RESULTS Overall, the results of CA did not match with the FTIR results in 56 % of the cases. In 16 % of the cases CA missed the major stone component and in 40 % the minor stone component. 37 of the 60 specimens contained CaOx as major component by FTIR, and CA reported major CaOx in 47/60, resulting in high sensitivity, but very poor specificity. CA was relatively accurate for UA and cystine. CA missed struvite and calcium phosphate as a major component in all cases. In mixed stones the sensitivity of CA for the minor component was poor, generally less than 50 %. CONCLUSIONS Urinary stone analysis using CA provides only limited data that should be interpreted carefully. Urinary stone analysis using CA is likely to result in clinically significant errors in its assessment of stone composition. Although the monetary costs of CA are relatively modest, this method does not provide the level of analytical specificity required for proper management of patients with metabolic stones.
Collapse
|
23
|
Abstract
Kidney stones are mineral deposits in the renal calyces and pelvis that are found free or attached to the renal papillae. They contain crystalline and organic components and are formed when the urine becomes supersaturated with respect to a mineral. Calcium oxalate is the main constituent of most stones, many of which form on a foundation of calcium phosphate called Randall's plaques, which are present on the renal papillary surface. Stone formation is highly prevalent, with rates of up to 14.8% and increasing, and a recurrence rate of up to 50% within the first 5 years of the initial stone episode. Obesity, diabetes, hypertension and metabolic syndrome are considered risk factors for stone formation, which, in turn, can lead to hypertension, chronic kidney disease and end-stage renal disease. Management of symptomatic kidney stones has evolved from open surgical lithotomy to minimally invasive endourological treatments leading to a reduction in patient morbidity, improved stone-free rates and better quality of life. Prevention of recurrence requires behavioural and nutritional interventions, as well as pharmacological treatments that are specific for the type of stone. There is a great need for recurrence prevention that requires a better understanding of the mechanisms involved in stone formation to facilitate the development of more-effective drugs.
Collapse
|
24
|
Vuiblet V, Fere M, Gobinet C, Birembaut P, Piot O, Rieu P. Renal Graft Fibrosis and Inflammation Quantification by an Automated Fourier-Transform Infrared Imaging Technique. J Am Soc Nephrol 2015; 27:2382-91. [PMID: 26683669 DOI: 10.1681/asn.2015050601] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 11/01/2015] [Indexed: 01/05/2023] Open
Abstract
Renal interstitial fibrosis and interstitial active inflammation are the main histologic features of renal allograft biopsy specimens. Fibrosis is currently assessed by semiquantitative subjective analysis, and color image analysis has been developed to improve the reliability and repeatability of this evaluation. However, these techniques fail to distinguish fibrosis from constitutive collagen or active inflammation. We developed an automatic, reproducible Fourier-transform infrared (FTIR) imaging-based technique for simultaneous quantification of fibrosis and inflammation in renal allograft biopsy specimens. We generated and validated a classification model using 49 renal biopsy specimens and subsequently tested the robustness of this classification algorithm on 166 renal grafts. Finally, we explored the clinical relevance of fibrosis quantification using FTIR imaging by comparing results with renal function at 3 months after transplantation (M3) and the variation of renal function between M3 and M12. We showed excellent robustness for fibrosis and inflammation classification, with >90% of renal biopsy specimens adequately classified by FTIR imaging. Finally, fibrosis quantification by FTIR imaging correlated with renal function at M3, and the variation in fibrosis between M3 and M12 correlated well with the variation in renal function over the same period. This study shows that FTIR-based analysis of renal graft biopsy specimens is a reproducible and reliable label-free technique for quantifying fibrosis and active inflammation. This technique seems to be more relevant than digital image analysis and promising for both research studies and routine clinical practice.
Collapse
Affiliation(s)
- Vincent Vuiblet
- Matrice Extracellulaire et Dynamique Cellulaire Unit, Centre National pour la Recherche Scientifique, Unité Mixte de Recherche 7369, and Nephrology and Renal Transplantation Department and Biopathology Laboratory, Centre Hospitalier et Universitaire de Reims, Reims, France
| | - Michael Fere
- Matrice Extracellulaire et Dynamique Cellulaire Unit, Centre National pour la Recherche Scientifique, Unité Mixte de Recherche 7369, and
| | - Cyril Gobinet
- Matrice Extracellulaire et Dynamique Cellulaire Unit, Centre National pour la Recherche Scientifique, Unité Mixte de Recherche 7369, and
| | - Philippe Birembaut
- Biopathology Laboratory, Centre Hospitalier et Universitaire de Reims, Reims, France
| | - Olivier Piot
- Matrice Extracellulaire et Dynamique Cellulaire Unit, Centre National pour la Recherche Scientifique, Unité Mixte de Recherche 7369, and Cellular and Tissular Imaging Platform, Université de Reims Champagne-Ardenne, Reims, France; and
| | - Philippe Rieu
- Matrice Extracellulaire et Dynamique Cellulaire Unit, Centre National pour la Recherche Scientifique, Unité Mixte de Recherche 7369, and Nephrology and Renal Transplantation Department and
| |
Collapse
|